Archive | March 2016

Part II Colorectal Cancer Awareness Month – Treatment on stages O and I of colorectal cancer.

colorectal-cANCER PERCENTAGE IN RISKSCOLORECTAL CANCER 2

Part II Treatment & Care

Many colon cancer treatment options are available for colorectal cancer, including surgery, chemotherapy, and radiation. Here’s what to expect from each type of treatment and tips for recovery.

Polyp Removal and Other Precancerous Conditions

Precancerous conditions of the colon or rectum are changes to cells that make them more likely to develop into cancer. These conditions are not yet cancer, but there is a higher chance these abnormal changes will become colorectal cancer.

The most common precancerous conditions of the colon or rectum area:

adenomas

hereditary colorectal syndromes

If you have a precancerous condition, you will likely have regular follow-up and screening tests to find cancer as early as possible if it develops. Some precancerous conditions can be treated with surgery to help reduce the risk that they will become cancer.

Colorectal Cancer Treatment

Stages of the cancer with TNM system for colorectal cancer helps determine the RX.

The most commonly used colorectal cancer staging system is known as the TNM system, which has been established by the American Joint Committee on Cancer. The TNM staging system looks at three key factors to determine the stage of cancer:

  • Tumor (T) looks at how far the primary tumor has grown into the wall of the colon or rectum, and if it has expanded into nearby areas.
  • Lymph node (N) examines the extent of the cancer spread to nearby lymph nodes.
  • Metastasis (M) refers to whether cancer has spread to other parts of the body, such as the liver, lungs or brain.

A number (0-4 stages) or the letter X is assigned to each factor. Using this colorectal cancer staging system, a higher number indicates increasing severity. For instance, a T1 score indicates a smaller tumor than a T2 score. The letter X means the information could not be assessed.

Stages of colorectal cancer diagnosis occurs in conjunction with the following TNM categories:

  • T1-T2: If the cancer has grown through the muscularis mucosa and into the submucosa, it is considered T1. Or, if the cancer has grown into the muscularis propria, then it is classified as T2.
  • N0: The cancer has not spread to the lymph nodes.
  • M0: There has been no spreading to organs or other nearby areas
  • Stage I colorectal cancer treatments

Once the T, N and M scores have been assigned, an overall stage is determined, and thus treatment options can be explored.

Here’s a quick rundown of the options available for colorectal cancer treatment from surgery to cutting-edge biologic therapy.

Colorectal Cancer: Treatment by Stages

STAGE 0 (IN SITU) Colorectal Cancer Treatment

Surgery for colon cancer

  • Polypectomy: snaring and removing polyps containing cancer during a colonoscopy.
  • Local excision: removal of flat colon growths “piecemeal” during colonoscopy.
  • Open abdominal surgery to remove cancer, part of colon, and nearby lymph nodes in high risk situations where:
    • There is a spread to polyp stalk
    • There is spread to lymphatic vessels (not lymph nodes)
    • Cells look very abnormal under the microscope (high grade)
    • Surgical margins (edge of tissue) contain cancer cells or can’t be evaluated or contain cancer cells.
    • Local excision would be too time-consuming or difficult to perform.

Chemotherapy

Chemotherapy is not recommended for stage 0 colon cancer.

Stage I Colorectal Cancer Treatment

Surgery

Colectomy (resection): Abdominal surgery to remove the section of colon where the tumor is located, tissue containing blood and lymph vessels surrounding the colon (mesentery), healthy tissue margins on either side, and at least 12 lymph nodes, if possible. Then the remaining ends of colon are reconnected with sutures or staples. This connection is called an anastomosis.

Open colectomy: An incision is made in the abdomen, surgery performed through the opening, and the incision closed with sutures and/or staples.

Laparoscopic colectomy: Three small keyhole incisions are made to insert a lighted instrument and specially designed surgical instruments that can be manipulated within the abdomen. Sometimes an incision is made just long enough for the surgeon’s hand to assist during laparoscopy.

Chemotherapy

Chemotherapy is not recommended for stage I colon cancer.

Part III on continuation of treatments of other stages of this condition (Stage II & III)

QUOTE ON WEDNESDAY:

“Most colon cancers develop first as polyps, which are abnormal growths inside the colon or rectum that may later become cancerous if not removed.”

Colon Cancer Alliance

 

Part I Colorectal Cancer Awareness Month

colorectal cancer2 colorectal cancer1

Colorectal cancer is cancer that develops in the tissues of the colon and/or rectum. The colon and the rectum are both found in the lower part of the gastrointestinal (digestive) system. They form a long, muscular tube called the large intestine (or large bowel). The colon absorbs food and water and stores waste. The rectum is responsible for passing waste from the body.

If the cancer began in the colon, which is the first four to five feet of the large intestine, it may be referred to as colon cancer. If the cancer began in the rectum, which is the last several inches of the large intestine leading to the anus, it is called rectal cancer.

Colorectal cancer starts in the inner lining of the colon and/or rectum, slowly growing through some or all of its layers. It typically starts as a growth of tissue called a polyp. A particular type of polyp, called an adenoma, can then develop into cancer.

Adenocarcinoma is the most common type of colorectal cancer. Other colorectal cancers include gastrointestinal carcinoid tumors, gastrointestinal stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma and squamous cell carcinoma.

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the colon or rectum, it is called colorectal cancer. Sometimes it is called colon cancer, for short.

Colorectal cancer affects men and women of all racial and ethnic groups, and is most often found in people aged 50 years or older. In the United States, it is the third most common cancer for men and women.

Of cancers that affect both men and women, colorectal cancer is the second leading cancer killer in the United States, but it doesn’t have to be.

Colorectal cancer screening saves lives.

Screening can find precancerous polyps—abnormal growths in the colon or rectum—so that they can be removed before turning into cancer. Screening also helps find colorectal cancer at an early stage, when treatment often leads to a cure. About nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later.

If you are aged 50 or older, get screened now. If you think you may be at higher than average risk for colorectal cancer, speak with your doctor about getting screened early.

While screening rates have increased in the U.S., not enough people are getting screened for colorectal cancer. In 2012, 65% of U.S. adults were up-to-date with colorectal cancer screening; 7% had been screened, but were not up-to-date; and 28% had never been screened.

Your risk of getting colorectal cancer increases as you get older. More than 90% of cases occur in people who are 50 years old or older.

Other risk factors include having:

*Inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.

*A personal or family history of colorectal cancer or colorectal polyps.

*A genetic syndrome such as familial adenomatous polyposis (FAP)hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lifestyle factors that may contribute to an increased risk of colorectal cancer include—

  • Lack of regular physical activity.
  • Low fruit and vegetable intake.
  • A low-fiber and high-fat diet.
  • Overweight and obesity.
  • Alcohol consumption.
  • Tobacco use. *Rectal bleeding or blood in your stool.
  • *Diagnosing colorectal cancer:Treatment & Care
  • Tests. Finding colon cancer early is key to beating it. That’s why doctors recommend a yearly fecal occult blood test, which tests for invisible blood in the stool, an early sign of colon cancer. One of the best tools for detecting colorectal cancer is a colonoscopy.
  • *Persistent abdominal discomfort, such as cramps, gas or pain.
  • *A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks.
  • *Signs and symptoms of colon-rectal cancer include:
  • Many colon cancer treatment options are available for colorectal cancer, including surgery, chemotherapy, and radiation. Here’s what to expect from each type of treatment and tips for recovery.

*Treatment= Get details on treatment on Part II tomorrow’s article Thurs.

Colon Polyp Removal and Other Precancerous Conditions

Learn how colon polyps are removed and why it’s so important to stay on top of these and other precancerous conditions.

Colorectal Cancer Treatment

Here’s a quick rundown of the options available for colorectal cancer treatment from surgery to cutting-edge biologic therapy.

Colon Cancer: Treatment by Stage

Here you’ll find detailed information on how the various stages of colon cancer are treated — from stage 0 to stage IV and also recurrent colon cancer.

Rectal Cancer Treatment by Stage

Here you’ll find detailed information on how the various stages of rectal cancer are treated — from stage 0 to stage IV and also recurrent rectal cancer.

Colon Cancer Chemotherapy

Learn about the different ways chemotherapy is used to treat colon cancer and rectal cancer and the side effects of commonly used chemotherapy drugs.

QUOTE FOR TUESDAY:

“Hemophilia is one of the more common inherited types of bleeding disorders. Currently, about 20,000 individuals in the United States have hemophilia. Although hemophilia most commonly occurs in men, it can also occur in women.”

National Hemophilia Foundation

 

March Awareness on Hemophilia.

hemophilia3hemophilia2

hemophilia1hemodialysis explained

What is this condition?

Hemophilia is a bleeding disorder characterized by low levels of clotting factor proteins. Correct diagnosis of Hemophilia is essential to providing effective treatment. Blood Center of Wisconsin offers one of the largest diagnostic menus to accurately and confidently diagnose Hemophilia.

The X and Y chromosomes are called sex chromosomes. The gene for hemophilia is carried on the X chromosome. Hemophilia is inherited in an X-linked recessive manner.  Females inherit two X chromosomes, one from their mother and one from their father (XX). Males inherit an X chromosome from their mother and a Y chromosome from their father (XY). That means if a son inherits an X chromosome carrying hemophilia from his mother, he will have hemophilia. It also means that fathers cannot pass hemophilia on to their sons.

But because daughters have two X chromosomes, even if they inherit the hemophilia gene from their mother, most likely they will inherit a healthy X chromosome from their father and not have hemophilia. A daughter who inherits an X chromosome that contains the gene for hemophilia is called a carrier. She can pass the gene on to her children. Hemophilia can occur in daughters, but is rare.

 

For a female carrier, there are four possible outcomes for each pregnancy:

  1. A girl who is not a carrier
  2. A girl who is a carrier
  3. A boy without hemophilia
  4. A boy with hemophilia

 

Hemophilia is an X-linked inherited bleeding disorder caused by mutation of the F8 gene that encodes for coagulation factor VIII or the F9 gene that encodes for coagulation factor IX. The degree of plasma factor deficiency correlates with both the clinical severity of disease and genetic findings. Severe hemophilia is characterized by plasma factor VIII or factor IX levels of under 1 IU/dl. Moderate and mild hemophilia are characterized by factor VIII or factor IX levels of 1-5 IU/dL or 6 – 40 IU/dL, respectively. Genetic analysis is useful for identification of the underlying genetic defect in males with severe, moderate or mild hemophilia and for determination of carrier status in the female individuals within their families. Additionally, data is emerging regarding the correlation between a patients mutation status and the risk of that patient developing an inhibitor.

People with hemophilia A often, bleed longer than other people. Bleeds can occur internally, into joints and muscles, or externally, from minor cuts, dental procedures or trauma. How frequently a person bleeds and the severity of those bleeds depends on how much FVIII is in the plasma, the straw-colored fluid portion of blood.

Normal plasma levels of FVIII range from 50% to 150%. Levels below 50%, or half of what is needed to form a clot, determine a person’s symptoms.

  • Mild hemophilia A-  6% up to 49% of FVIII in the blood. People with mild hemophilia Agenerally experience bleeding only after serious injury, trauma or surgery. In many cases, mild hemophilia is not diagnosed until an injury, surgery or tooth extraction results in prolonged bleeding. The first episode may not occur until adulthood. Women with mild hemophilia often experience menorrhagia, heavy menstrual periods, and can hemorrhage after childbirth.
  • Moderate hemophilia A. 1% up to 5% of FVIII in the blood. People with moderate hemophilia A  tend to have bleeding episodes after injuries. Bleeds that occur without obvious cause are called spontaneous bleeding episodes.
  • Severe hemophilia A.  <1% of FVIII in the blood. People with severe hemophilia A experience bleeding following an injury and may have frequent spontaneous bleeding episodes, often into their joints and musclesHemophilia A and B are diagnosed by measuring factor clotting activity. Individuals who have hemophilia A have low factor VIII clotting activity. Individuals who have hemophilia B have low factor IX clotting activity.Genetic testing is usually used to identify women who are carriers of a FVIII or FIX gene mutation, and to diagnose hemophilia in a fetus during a pregnancy (prenatal diagnosis). It is sometimes used to diagnose individuals who have mild symptoms of hemophilia A or B.There is currently no cure for hemophilia. Treatment depends on the severity of hemophilia.People who have moderate to severe hemophilia A or B may need to have an infusion of clotting factor taken from donated human blood or from genetically engineered products called recombinant clotting factors to stop the bleeding. If the potential for bleeding is serious, a doctor may give infusions of clotting factor to avoid bleeding (preventive infusions) before the bleeding begins. Repeated infusions may be necessary if the internal bleeding is serious. When a person who has hemophilia has a small cut or scrape, using pressure and a bandage will take care of the wound. An ice pack can be used when there are small areas of bleeding under the skin.
  • When bleeding has damaged joints, physical therapy is used to help them function better. Physical therapy helps to keep the joints moving and prevents the joints from becoming frozen or badly deformed. Sometimes the bleeding into joints damages them or destroys them. In this situation, the individual may be given an artificial joint.
  • Treatment may involve slow injection of a medicine called desmopressin (DDAVP) by the doctor into one of the veins. DDAVP helps to release more clotting factor to stop the bleeding. Sometimes, DDAVP is given as a medication that can be breathed in through the nose (nasal spray).
  • Treatment of the condition:
  • Genetic testing is also available for the factor VIII gene and the factor IX gene. Genetic testing of the FVIII gene finds a disease-causing mutation in up to 98 percent of individuals who have hemophilia A. Genetic testing of the FIX gene finds disease-causing mutations in more than 99 percent of individuals who have hemophilia B.
  • For Diagnosing the condition:

Researchers have been working to develop a gene replacement treatment (gene therapy) for Hemophilia A. Research of gene therapy for hemophilia A is now taking place. The results are encouraging. Researchers continue to evaluate the long-term safety of gene therapies. The hope is that there will be a genetic cure for hemophilia in the future.

QUOTE FOR THE FRIDAY:

“It’s not easy to diagnose because depending where the endometrial deposits are, the symptoms can be quite different. It’s an unrecognized problem among teenage girls, and it’s something that every young woman who has painful menstruation should be aware of … it’s a condition that is curable if it’s caught early.

[Author Hilary Mantel on being asked about being a writer with endometriosis, Nov 2012 NPR interview]”

The Month of Endometriosis.

possible-sites-of-endometriosis

The uterus is a female reproductive organ located between the bladder and the rectum, in the pelvic area. The uterus has three layers: the inner lining (endometrium); the middle muscular layer (myometrium); and the outer layer (perimetrium). The uterus is connected to the fallopian tubes, the cervix and (via the cervix) the vagina.

Endometriosis is a painful, chronic disease that affects at least 6.3 million women and girls in the U.S., 1 million in Canada, and millions more worldwide. It occurs when tissue like that which lines the uterus (tissue called the endometrium) is found outside the uterus — usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, and other locations.

This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation — and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.

Pain before and during period: Pain with sex, Infertility, Fatigue, Painful urination during periods, Painful bowel movements during periods and Other Gastrointestinal upsets such as diarrhea, constipation, nausea.

In addition, many women with endometriosis suffer from:

  • Allergies
  • Chemical sensitivities
  • Frequent yeast infections

Diagnosis is considered uncertain until proven by laparoscopy, a minor surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the growths. This helps the doctor and patient make better treatment choices.

What Causes Endometriosis?

The cause of endometriosis is unknown. The retrograde menstruation theory (transtubal migration theory) suggests that during menstruation some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen, and grows.  Some experts believe that all women experience some menstrual tissue backup and that an immune system problem or a hormonal problem allows this tissue to grow in the women who develop endometriosis.

Another theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymph system or through the blood system. A genetic theory suggests that it may be carried in the genes in certain families or that some families may have predisposing factors to endometriosis.

Surgical transplantation has also been cited in many cases where endometriosis is found in abdominal scars, although it has also been found in such scars when accidental implantation seems unlikely.

Another theory suggests that remnants of tissue from when the woman was an embryo may later develop into endometriosis, or that some adult tissues retain the ability they had in the embryo stage to transform reproductive tissue in certain circumstances.

Research by the Endometriosis Association revealed a startling link between dioxin (TCCD) exposure and the development of endometriosis. Dioxin is a toxic chemical byproduct of pesticide manufacturing, bleached pulp and paper products, and medical and municipal waste incineration. The EA discovered a colony of rhesus monkeys that had developed endometriosis after exposure to dioxin. 79% of the monkeys exposed to dioxin developed endometriosis, and, in addition, the more dioxin exposure, the more severe the endometriosis.

QUOTE FOR THURSDAY:

“Since 1962, the President of the United States has proclaimed the third week of March as National Poison Prevention Week to raise awareness about the dangers of poisonings and how to prevent them.”

AAPCC – American Association of Poison Control Centers